"The 1,300-page report published yesterday ... the fifth into the murderous activities of the Manchester GP [Harold Shipman], is the most damning yet and concludes that the procedures and culture of the General Medical Council (GMC) are fundamentally flawed ...

"[Dame Janet Smith] makes at least 100 proposals. The most far reaching is the composition of the GMC itself. It should, in future, have far greater lay membership - an overdue change to ensure more independence from the medical profession and one which other professional bodies, such as the Law Society, have also recently implemented. Self-regulation must be the norm for professions dependent on expertise, ethical commitment and professional pride. But she also calls for periodic re-evaluation of doctors to ensure continuing competence. And she calls, sensibly, for greater transparency, a database on doctors' records and public information on those who have been disciplined. The likelihood of another Shipman is thankfully remote; and the govern ment should be wary of overreacting with new regulations that stifle professional initiative. But the GMC must take Dame Janet's strictures extremely seriously."

Independent Editorial, December 10

"The latest report from the Shipman inquiry calls into question not only the medical profession's ability to regulate itself, but the very survival of the GMC. The inquiry's chairman, Dame Janet Smith, yesterday painted an unflattering picture of an organisation that is supposed to be the medical community's watchdog but has become its lapdog instead ... [The report] makes abundantly clear that the regulator has neglected its duty of care towards the general public ... The GMC's only hope is to strike a balance between being part of the medical profession and serving the public. An acceptance that its job is to put patients first, not doctors, would be a useful start."

Daily Express Editorial, December 10

"Even in the Shipman case, the prevalent attitude among GPs ... was that it 'was not done' to question and report a fellow doctor. As we now know, such an attitude resulted in an enormous loss of life. In other cases this closing of ranks has led to appalling examples of medical negligence and sexual abuse going unreported. That is why Dame Janet's recommendation for a hotline to shop rogue GPs, and her call to replace the GMC with an independent body to discipline doctors, must be acted upon. Patients must be protected from rogue GPs and the profession has shown it cannot do that itself."

Daily MirrorEditorial, December 10

"For years there have been complaints about the easy ride the GMC gives bad doctors. But it has taken the murder of more than 200 patients to get anything done. It has been a sick joke that the only time a doctor was struck off was if he had an affair with a patient. If, however, he killed her through poor medical treatment he got away with it. That attitude of protecting their profession rather than their patients meant the GMC failed to crack down on Shipman ...

"Dame Janet Smith's report yesterday was scathing about the GMC and demanded changes. At last, they will have to come. Not because the majority of doctors need disciplining - most are dedicated, efficient and responsible. But the few rotten apples must be weeded out. Never again can the old boy network be allowed to protect useless doctors at the expense of patients' lives."

Herald Editorial, Scotland, December 10

"The report depicts an organisation which, rather than protecting patients, operates more like a cross between an old boys' club and a trade union for medics. There remains an unwillingness to report doctors who fall short. The GMC also operates essentially as a closed shop, acting as judge and jury ...

"Dame Janet falls short of directly blaming the GMC for the 200 or more murders that Shipman went on to commit, because the council lacked sufficient information. That might not have been the case if there had been a central database of the kind she recommends, pooling information about doctors from the GMC, the NHS and police records. There must also be an improved mechanism for members of the public to make complaints and report suspicions ... As Dame Janet concludes, reforms to date have been woefully inadequate. At the current rate of progress, the GMC could become Harold Shipman's final victim."

Celia Hall Daily Telegraph, December 10

"Dame Janet ... may have stopped short of recommending that the council be abolished but her central recommendation, if accepted, would emasculate the GMC ... [She says] the task of adjudicating in the cases of accused doctors should be handed over to an independent tribunal. The GMC is likely to fight to keep its powers and the medical profession as a whole prefers a system of self-regulation. The question now is whether or not the GMC has earned the right to keep it ...